4 胆囊管残株结石的诊断和治疗:附22例报告

目的探讨胆囊管残株结石的诊断和治疗方法。方法回顾性分析18年间收治的22例胆囊管残株结石患者的临床资料。结果22例中18例行ERCP确诊6例,MRCP确诊12例;另4例因胆总管结石进行胆总管探查术时发现残留胆囊管过长且有结石,术中胆道造影证实为胆囊管残株结石。全部患者经再次手术治疗获得痊愈,术后随访3年以上,效果满意。结论胆囊管残株结石与第1次手术密切有关,MRCP和ERCP是其最有价值的诊断方法。再次手术难度大,手术应谨慎。

Diagnosis and treatment of cystic duct stump concretion:a report of 22 cases

Objective To explore the diagnosis and treatment of cystic duct stump concretion.Methods The clinical data of 22 cases of cystic duct stump concretion were retrospectively analysed.Results Of 22 cases,six cases were diagnosed by ERCP;12 by MRCP;and the other four cases had long cystic duct stump with stones found at operation,and proved by intraoperative cholangiography.All cases were cured by re-operation,and at more than 3 years follow up,the results were satisfactory.Conclusions The cystic duct stump concretion is closely related to the first operation.MRCP and ERCP are the most valuable diagnotic methods.Re-operation is difficult and needs to be done with care.